treatment

[jhakas]

Hi All,

I have a question ... WHEN do you think a person should start treatment ? I mean what are the indication ( ALT AST level , test s ) suggests that the person is a canditate of treatment..

Another question is does a person HAVE to go on a treatment some time or the other in his life, isnt it possible that the virus just sits there and does nothing in its entire lifetime ??

thanks in advance

[stevenNYer]

Don't think of the eAntigen and eAntibody as a light switch, that either goes on and off.  It's a balance and they are often both in your system.  It's a matter of balance of which one overtakes the other.

So to answer your question, someone who successfully eSeroconverts (without escape mutants) is more stable that someone who achieves sSeroconversion with antivirals.  When it's natural, we know it's your immune system that is holding the virus down.  If you treat, it maybe that the virus is held down by antivirals and not your immune system.  Your immune system is still working but it's still lagging behind of the virus' bag of tricks to adapt.  So with less virus in your system, the eAntigen production goes down so your modest amount of the exsiting eAntibody overtakes the existing eAntigen.  But if you take away the anitviral(s), your immune system may not be able to hold the virus, the virus increase in numbers making more eAntigen and overtake the eAntibody again and then it flip flops back.  This is why it is suggested that if you achieve the eSeroconversion with the help of antiviral(s), you should still stay on it for at least 6 months, preferably 1 year.  This will give it more time to stablize, further reduce the viral burden to your immune system, then hope it holds.

[jhakas]

Bump

[jhakas]

Hi

I have a question, normal advise ,

Patient 1. Those who are HbeAg  + ve .... treatment is recomended till seroconversion is acheived.
Patient 2. Those who are natrually Hbeag - ver long term is required until Hbsag is - ve


Now my question is reading all these  points ... after patient1  achieves seroconversion  whats the diff between patient 1and patient 2 ???
Once patient 1 acheive Hbeag - ve dont he have to start treatment to all his life until Hbseag is negative ???

[zellyf]

It is possible to go your whole (standard length) life w/o needing treatment but at this point you would probably be the exception rather than the rule as the guidelines for treatment seem to include more and more of the group once considered "inactive".  

[bberry]

agree with sharp75

[Sharp7]

http://www.hepb.org/patients/who_should_be_treated.htm

pages 7 and 8 of http://www.aasld.org/practiceguidelines/Documents/Practice%20Guidelines/chronichepBcorrection.pdf

more options at http://www.hepb.org/treatment/

To answer your second question: as you can see in the documents above, treatment is not recommended at all in many cases. Researchers have tried various drugs on people who do no need treatment (according to the latest guidelines) and discovered that the drugs do not help at all. That is why the latest guidelines recommend "no treatment" in many cases.